So can everyone who mocked Sarah Palin's "death panel" remarks please raise their hand? Thank you. You and your incompetent Government employees are not allowed to make decisions about my health care anymore. Do you get that? Good, now go on about your lives and in the future stay out of issues that you don't understand.

So many of the posts on this drug paint it as a one-size-fits-all cancer drug. Is it? If a doctor does not prescribe Avastin (that name cracks me up ever since -- who was it -- called is YeeMatiesIn!) for a cancer patient, would they be sued? If the answer to that is yes, unquestionably, then I don't think the Government should restrict access to the drug. It sounds like it's worthwhile.

If the answer is not yes, however, I'm not alarmed that a person other than the doctor and patient might arrive at the most cost-effective treatment for the patient that does not include Avastin.

The key is for the patient to be a good advocate for their care, which means knowing all their options.

In Canada they will claim they do have death panels. You just have to wait six months or more for a procedure that in the States would take a week to set up. That unfortunately is the price of socialized medicine. There is never enough money to pay for everything.

If you were getting no health care before, the Canadian system is a definite improvement. If you had insurance and were getting health care, chances are you would be getting less health care under a Canadian system.

That is the issue. And health care legislation was a huge step in that direction.

Bullshit. Read the article. Then go to any number of articles that clearly show, as this article doesn't want to admit clearly, that Avastin does not cure nor does it provide relief in any statistically meaningful way - that means metastatic breast tumors aren't cured and only in a third of the cases did they prolong life more than a month or two at best.

This is from the Avastin.com web site:

"There are no data demonstrating an improvement in disease-related symptoms or increased survival with Avastin."

"If you were getting no health care before, the Canadian system is a definite improvement. If you had insurance and were getting health care, chances are you would be getting less health care under a Canadian system.

That is the issue. And health care legislation was a huge step in that direction."

"ODAC's advice is not binding, and the FDA will deliver its final judgment in September. It would be a hideous injustice if the agency came down once more on the wrong side of a life-and-death question."

1. This isn't the kind of "death panel" that Palin was hypothesizing about. She was talking about a review board that decides on a case-by-case basis whether an efficatious but expensive treatment benefitting an old person would be paid for by the government. This already happens in the UK.

2. The timing of a negative decision by the FDA, just before the election, could put Republican congressional campaigns on afterburners.

Yes Death Panels. Libs acted like since the words "Death Panel" wasn't in the bill that they weren't in there.

Here's how death panels work. Say you have an elderly woman who needs a treatment. The treatment is Very Expensive(tm). If she doesn't get the treatment, she will die. If she does get the treatment, she only has a 30% chance of living. She wants to have the treatment, the doctor wants to give her the treatment.

Who decides if she is allowed to have this procedure? Some bureaucrat somewhere. Or maybe a panel of them. This is what we call a death panel, because they are making decisions like this very decision here, that will kill some people in order to save money.

This right here is exactly what Palin was talking about and you all said would never ever happen.

"Patients did not live longer—that is, the overall survival rate did not improve in a statistically significant way. Yet a clinical trial showed a 52% median improvement in "progression-free survival," which measures the time women live without their disease spreading or worsening. In practice, this means delaying the growth of tumors by about 11 months in combination with chemotherapy—five and a half months longer than chemo alone."

She will die anyway; we all will since the mortality rate remains 100%. How much is it worth to prolong one life for a month, 3 months, 6 months? That is to say, how much of someone else's money is it worth? In my case, a lot. Everything you got. You're not willing to give me all your money to keep me alive? What are you, some kind of one-person death panel?

Scott said..."Patients did not live longer—that is, the overall survival rate did not improve in a statistically significant way. Yet a clinical trial showed a 52% median improvement in "progression-free survival," which measures the time women live without their disease spreading or worsening. In practice, this means delaying the growth of tumors by about 11 months in combination with chemotherapy—five and a half months longer than chemo alone."

Jesus Scott are you braindead?

Avastin states that it is of no use and shouldn't be used or attempted on patients who have undergone chemo. The drug company also states that it has shown no data decreasing symptons and increasing survival.

You can take what the WSJ writes second hand and perhaps with motive or you can take what the drug company and the FDA both say about the drug in use on metastatic breast cancer. I don't care but you have got to demonstrate a better reading comprehension ability than you are showing thus far.

you'd think people with fat unsustainable government pensions would be against medical decisions based on what saves the government the most money. they must think the issue of "cost" will be narrow and compartmentalized, which it will be until it isn't.

Is it a death panel or isn't it? Does it matter what the patient does with that month? If it gives 30% of women an extra month, should we give it to 100% of women (for whom it's approrpaite treatment)?

What if her first grandchild is due to be born during that month or her youngest son is graduating college or getting married during that month?

That $90k might not be worth it to you, but it might be worth it to her. What if the FDA rescinds approval, but I am willing to pay for it myself? Should I have access to life-extending drugs and treatments that I want to have? I can't have them if they're not FDA-approved.

I was part of a clinical trial for the drug for ovarian, not breast, cancer. I think it probably helped me, but I am one case.

I don't want someone in the government deciding what is "reasonable and necessary" for my treatment.

Yes, I want the FDA to decide whether drugs are efficacious and safe. I don't want the FDA engaging in cost-benefit analysis.

From the Telegraph: "The [FDA] panel unusually cited 'effectiveness' grounds for the decision. But it has been claimed that 'cost effectiveness' was the real reason ahead of reforms in which the government will extend health insurance to the poorest."

An $8000 cost for one month seems like a bargain to me. If the quality of life during the extended month(s) is lousy, then let the patient and doctor decide whether to suspend treatment.

Well, the death panels have always been hiding in plain sight. The whole idea of ObamaCare's centrally controlled allocation of resources is that some central authority will control the allocation of medical resources. If that central authority decides that allocating resources to any particular treatment does not provide enough bang for the buck, they refuse to make the allocation and, presto!, those resources will not be available to anyone dependent on the centralized system. Is that so hard to grasp? It's amazing that anyone could possibly miss it.

A centralized medical system, particularly one like ObamaCare premised on removing any connection between the cost of care and the consumer's decision to use/not use a particular treatment option, has to come up with an alternative allocation system. Death panels are an essential and unavoidable feature of any centralized system of providing medical care.

The same is true when insurance companies are deciding whether to cover a particular treatment. The difference between the two is that, when it's an insurance company refusing to allocate resources to a treatment claimed to be essential to a patient's survival, the politicians have someone to attack and the patient has recourse to an outsider (often the judicial system) with authority to override the insurer's decison. When government displaces all of that, who is left for the politicians to demagogue and what authority can the patient invoke to seek relief?

The economics of all of this has been a staple of Law-and-Econ analysis for decades. It's gotten much more sophisticated than Calabresi's Cost of Accidents and Tragic Choices (two of the leading texts in my law school days), but the necessity of having to make the allocation decision never changes. Wishing it were otherwise doesn't help. If it's anyone other than the individual patient (or family), you will always have the death panel problem. But no one really likes the idea that cost should be a determining factor, when the reality that resources are not infinite means that it ultimately always will be.

Who decides if she is allowed to have this procedure? Some bureaucrat somewhere. Or maybe a panel of them. This is what we call a death panel, because they are making decisions like this very decision here, that will kill some people in order to save money.

Is there something in the 2200 pages (or however many) that would prevent her from buying the drug herself (with a doctor's prescription, of course)?

My parents tell me that they've saved up quite a bit of $$ for any health emergencies (that they're willing to help fund the daughter's college with, if needed, which is how I learned of it). I wonder if they would use that $$ to buy a couple courses of Avastin if they needed it (I suspect they would not need to because -- knock wood -- my family history doesn't have a lot of cancer deaths; heart attack and stroke, yes. Cancer, no). I suspect not. My experience with dying old people is that some of them are pretty realistic about what can/cannot should/should not be done. Everyone does die. I think once you get past 85 and have outlived many of your friends and relatives, you really do understand that.

"Avastin states that it is of no use and shouldn't be used or attempted on patients who have undergone chemo. The drug company also states that it has shown no data decreasing symptons and increasing survival."

Most doctors, and especially oncologists, go "off the indicia" to try things that might work. They are not constrained by the attorneys who write the boilerplate that keeps drug companies from being sued. The only issue might be whether or not the insurance company will pay for the drug; and the indicia speaks to that issue.

If a rich woman wants to live an extra five months, why should she be prohibited from forking over $80,000 or so for the privilege?

Elections have consequences. There are a lot of people out there stuttering, "But, but, but, that wasn't what I wanted! That wasn't what I voted for!" Surprise, surprise, surprise! Yes, it was. How's that hopey-changey business working out for you?

The medical left has gotten the power that it has always craved for and that is the right to decide who lives or dies by controlling economics. Plain and simple. And the rest of the left wing knows this. Combined with the narcisism of baby boomers and you have a recipe for disaster except of course for upper west side elites.

the follow-up outcomes were not as robust as the original verdict. One trial showed a 36% improvement, another 31%. Critics claim these effects are worthless because they translate into only one to three extra months before tumors worsen. But variation is to be expected over several studies...Remember, too, that these are only averages over a narrow population, while individual patients respond in dramatically different ways. That includes prolonging survival, which Avastin does in some situations. The median overall survival benefit for one subgroup of 496 patients between the ages of 40 and 64 was an additional 5.7 months of life.

In related news:

"It's way premature to say this strategy doesn't work. I think the strategy will continue to be of interest as a means of improving survival." DR. JOHN DURANT executive vice president of the American Society of Clinical Oncologists

Dr. Durant was responding to a decision by Dr. Lee Newcomer,medical director of United Health Group and oncologist.

How many of these partisan idiots who are ignoring the reality of what is being discussed in the article have pink ribbons on their cars? How many do walk-a-thons or give money for breast cancer research at least once a year? I bet a whole lot of them. But when their egos, and political biases are at stake, they kick the actual women with cancer to the curb. That's how Liberals always operate, and it's just one more reason that they are so despised that they have to call themselves "Progressives" nowadays. Ugly people with ugly motives doing ugly things.

Avastin is approved, just not for MBC. There is no penalty for prescribing off-label uses of drugs.

This is just the usual right-wing fearmongering and hysteria build-up

In some ways, I have to agree with FLS on this. People are confused and hysterical.

Medicare Part A and B will not cover this and also doesn't cover MANY other drugs and procedures. I'm not clear if the FDA ruling will affect Medicare Suppliment plans, but I imagine that they will drop coverage of the drug if they already carry it.

However, if you are not of Medicare age your private insurance may cover this drug.

The tempest about this is that it is a forerunner of what can happen to us ALL when we are ultimately forced into mandatory Government universal single payer coverage (or whatever is the latest term for socialized medicine).

Currently if you have private coverage or can afford it, you can probably get this drug and other proceedures.

The reality is that no coverage is going to be unlimited or will cover everything to the same levels. It just can't be done. Or as the Stones said: you can't always get what you want.

However, when the Government is in charge, THEY will decide and we will have NO alternatives.

If Ann was blogging during the Clinton Administration, she would have been blogging about how HIllary Clinton murdered over a dozen people - which YES - the Wall Street Journal Editorial page implied about 500 times.

By the way - insurance companies refuse to cover this drug as well. So why the hell should the federal government?

If the data says that it is not effective for breast cancer (and it sure seems that way), then yes, that is exactly what FDA's role is.

As an example: Arsenic. Arsenic is a poison, and was used as a medical treatment for various things for years. In fact, it is still used for severe parasitic situations. Does that mean the FDA should approve it for other situations where other, better drugs are available?

Don't you guys think you're taking the "I don't want the government to take this decision" thing a bit too far?

Dr. Newcomer and Dr. Durant were at opposite opinions regarding bone marrow transplant for metastatic breast cancer. The time was the late '90's. There were similar cries of impersonal decision makers making decisions solely on money and letting women die.

Is there something in the 2200 pages (or however many) that would prevent her from buying the drug herself (with a doctor's prescription, of course)?

I dunno-and you don't either-but there's nothing to stop such a law from being passed in the future. Exactly such a law was passed in Canada after they fully implemented socialistic medical care-to stop the "unfairness" of people using their own money to pay for treatments in a timely manner, or treatments that they couldn't get through the state controlled system. Wanna know where the largest concentration of medical imaging equipment in the world is? Upstate New York, serving Canadians crossing the border to get tests completed quickly. My wife had to wait over a month to get a simple x-ray wile living in Calgary. A MONTH! For a single x-ray!

Your naivete in believing that the government wouldn't pass such a law in a heartbeat (all in the name of "equality", of course) would be cute if the reality wasn't so terrifying.

From the WSJ article: Please note the result is in context with Chemo. "Yet a clinical trial showed a 52% median improvement in "progression-free survival," which measures the time women live without their disease spreading or worsening. In practice, this means delaying the growth of tumors by about 11 months in combination with chemotherapy—five and a half months longer than chemo alone."

From Avastin's website:"Avastin in combination with paclitaxel, a type of chemotherapy, is approved for treating patients with HER2-negative metastatic breast cancer (MBC) who have not yet received chemotherapy for their advanced disease. The effectiveness of Avastin in HER2-negative MBC is based on an improvement in how long your tumor remains controlled. Currently, there are no data available showing that Avastin improves disease-related symptoms or survival in HER2-negative MBC. Avastin is not approved for people who have received prior anthracycline and taxane (chemotherapy) for their HER2-negative MBC."

Avastin is NOT approved with chemo. And yet, the WSJ article states its effectiveness along with Chemo. Does anyone not question this cherrypicking?

The National Redistribution goes into effect just in time. The scientific reasoning is catching up with new words for good old fashioned Malthusian problem solving. Lower the incredible and unsustainable life expectancy from 82 to 67. All Social Security and Medicare budgets will be re- balanced. The government stooges want to solve the problem by pushing death over life. No wonder the Democrat majority Congress punted this issue to panels. The Tea Party is not stupid enough to lie down for their early death as they are portrayed over and over as being. Congress makes panels and Congress can kill panels.

No more of a "death panel" than my insurance which has a limit on how much it will spend on me, and which requires second opinion and justification for certain procedures. Interestingly in Europe,where Avastin is used to some degree, the majority do not receive it because of costs; here only if you are on Medicare would you get the drug as private insurance agencies will set up hurdles--And of course there are many risks with this drug-- , but the articles point out that a new drug Sanofi-Aventis BSI-201 will probably become the drug of choice because of over-all improvement in survival rates that are longer than the five and half months cited in Avastin's research.

@edutcher"The Feds blocking on the basis of cost is really is the beginning of what Miss Sarah predicted.That our National Socialists are objecting to something this clear shows what shameless shills they are."

And today's idiot award goes to....

Can't you read? the FEDS ARE NOT blocking based on cost. They are not blocking. They simply say it DOESN'T. Avastin says it doesn't work. You are just so damn "i wanna believe what i wanna believe"..which is fine. you be stupid. just stop with the boatload of bad information you bring to shore every time you hit the keyboard.

In your cited piece, you talk about "right wing lies". I am curious, what do you call the willfull misrepresentation of facts? Every socialized medical system in the world has panels that decide what will and won't be covered, what treatments will and won't be administered. Canada does, and France, and Germany. England, God, England's got them worse than anybody, don't get sick in England! (not that private insurance companies don't have analogous bodies, they absolutely do, but their decisions are subject to appeal-to the courts, state insurance commissioners, etc.. the state panels are not subject to appeal, and if they deny life saving treatment, you're done.) These bureaucratic panels are well documented, and so are their decisions, and the resultant deaths. "Death panel" is all too often exactly what they are. I don't understand how you can rail against "lies" while ignoring the facts beneath your nose. Are you so enamored of a fantasy, an imaginary utopia of state run health care that doesn't exist anywhere it's been tried, that you ignore facts right under your nose? Is it really better to be cocooned in wistful ignorance than to face reality? It doesn't seem so to me, but I've always been pragmatic, pie in the sky, rainbows and unicorn delusions repel me. Maybe you're different. *shrug*

"No more of a "death panel" than my insurance which has a limit on how much it will spend on me,"

Except for the 'voluntary agreement' thingy, which is gone, and that Doofus Insurance is not run by unelected unaccountable gummint officials, and that you could spend your money elsewhere if you didn't like it, but not anymore

2. the medical delivery system you ad hominem are spooked about actually does a lot better job of keeping citizens alive and healthy on every measurement from infant mortality to life expectancy.

3. when someone purposefully distorts - not an "error" but carefully worded distortions or omissions that can cause problems for others - either in expectations or in decisions made as a result - I call those lies.

Bullshit, Ann. No-one has to stand up before a panel that decides whether they live or die. You are talking about one medicine.

Your issue is different. You seem to want any medicine prescribed to be funded. I've not formed my opinion on that.

Here is how Palin described the "death panels:"

""The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."-- Facebook, Aug. 7, 2009"

OK FormerLawStudent, you're not thinking big picture. Sure this one drug can be prescribed off-label, but let's pretend that it's a brand-new drug not currently FDA-approved for any reason that's getting the cost-benefit analysis. Let's pretend it's a drug that works but only offers a small improvement in quality or length of life, but it does work at a statistically significant level and it's terribly expensive.

And let's say I want it, but the FDA says it's not cost-effective so they won't approve it. Big Picture.

Ankur - All I am asking you guys is to do is juxtapose these two sentences.

[snip]

Avastin is NOT approved with chemo. And yet, the WSJ article states its effectiveness along with Chemo. Does anyone not question this cherrypicking?

I think the defining difference is the word "prior". Avastin is not approved for people who have undergone chemotherapy prior to being proscribed Avastin. However, a combination of Avastin and chemotherapy appears to have some success.

My oncologist informed my that my radiation therapy was a one-time-only thing. I could never get any more in that area of my body due to severe consequences. I would not be surprised if a patient's system was not up to handling two rounds of chemotherapy plus Avastin.

Regarding your comment on chemotherapy, the article is referring to its approved use in combination with paclitaxel.

See the first part of the sentence in your quoted passage: "Avastin in combination with paclitaxel, a type of chemotherapy, is approved for treating patients with HER2-negative metastatic breast cancer (MBC)who have not yet received chemotherapy for their advanced disease."

The article does not discuss that "Avastin is not approved for people who have received prior anthracycline and taxane (chemotherapy) for their HER2-negative MBC.", but it is not really relevant, since this just indicates the patient population for which the drug has been assessed in clinical trials and shown to have some level of anti-tumor effect (but not survival benefit).

The article is not inaccurate on this point, it just doesn't explain the nuance.

It's the entire process, which, as Democratic Party leaders admitted, was merely a first step toward a national health service, by destroying private insurance.

Why would universal health care destroy private insurance, when the two are compatible in many advanced countries?

Universal health care in the Netherlands is provided by private insurers. Universal health care in Germany is provided by the government (for moderate income earners) and by private insurers (for high income earners). Universal health care in Israel is provided by one of four HMOs, originally established by trade unions.

Why does everyone think that privatizing death panels is somehow more acceptable?

Because you can pick and choose which death panel you want to deal with?

Seriously. Because in a free market place of insurance carriers, those that are too restrictive will not get the business of those who can and will go elsewhere.

Not everyone NEEDS or wants certain coverages so if I don't care about the 'cancer' drug being covered, I can CHOOSE on my own to go to a company that for a lesser premium will give me the coverage that I need and want.

On the otherhand if I'm concerned about cancer, I can purchase coverage at a higher cost that may cover those things.

When it is the Government deciding. It is a one size fits all and I don't have a CHOICE (note the large letters for emphasis CHOICE) to go to another company or to pay more or less for my coverage.

Oh Pogo please give me a break, as though insurance companies really are competitive; they all set rates on how much will be spent on procedures and deny coverage for some approaches. From my experience, I have discovered the case for good health care is a matter of luck and who you know in the medical profession. As of yet there is no silver bullet for cancer treatment,and limiting the use Avastin for breast cancer is not a major set back-- as I pointed out other treatments are in the pipe line.

"The insurance argument doesn't wash because you can always go to another insurance company."

That's not much of an answer. Most medical insurance is provided by the employer; employees (i.e., the consumer) sometimes has a choice between different plans offered by the employer but that is usually the case only for public employees or those employed by large businesses. But the main problem with the "choice of insurance plans" argument is that it never comes to grips with the real problem.

There are lots of things wrong with ObamaCare. But it's useless to pretend that having a decision about one's medical care made by others is unique to it. That is a feature of any system where the consumer is not paying for the cost of treatment. Where the consumer is paying the cost of treatment, the pricing system deals with allocation issues (just as it does with the allocation of Rolls Royces, Chevy Volts and everything else in a consumer economy). Once the pricing system is no longer the device used to allocate medical resources, you have to come up with an alternative. Because resources are not infinite, whatever system is chosen will have the unhappy task of telling some consumers (patients) that they cannot have the treatment they want. While some patients will be able to pay for the cost of the treatment anyway (assuming that option is available), many won't.

That reality is the driving force behind ObamaCare -- for many people, the idea that someone will be denied potentially life-saving treatment because they can't afford it is unacceptable. The dirty little secret of ObamaCare (or any other nationalized health system) is that it doesn't avoid that problem -- it's built into any allocation system -- but just tries to hide it while providing a wildly inefficient alternative.

Stories like this one about Avastin present the reality in a stark light. That's why apologists for ObamaCare will try to pretend that it just ain't so, and will look very foolish in doing so.

Ha ha ha.That's gonna dry up right quick, since gummint will demand to take for free or below cost what others spent millions on bringing to market.No one can afford to do that for long.So goodbye, innovation.

1. Not yet, isn't that what we're discussing? It's what I'm discussing.

2. It most emphatically does NOT. 5 year cancer survival rates in the US are the highest in the world. So is life expectancy (if you correct for deaths from violence and automobile accidents. Both are problems. Both are much higher than the world average. Neither has anything to do with health care). Infant mortality figures are skewed by a lack of consistency across countries WRT reporting methods (many countries don't count babies that never leave the hospital in their stats, others require certain minimum thresholds like weight, etc..to count. In the US they are all counted), but riddle me this: Your wife is in hard, complicated, premature labor at 24 weeks. You have the option of receiving the average medical care for her in any country in the world. Which country shall I put y'all in? The vaunted WHO report listing the US at 37th in the world for health care used "availability of government paid health care (socialized medicine) as one of it's chief metrics, of course the US ranked low on that, on everything else we ranked at or near the top. Your statement here just simply isn't true.

3. By your metric, your point number2 is a bald faced lie, and I suspect you know it.

“Except for the 'voluntary agreement' thingy, which is gone, and that Doofus Insurance is not run by unelected unaccountable gummint officials, and that you could spend your money elsewhere if you didn't like it, but not anymore.”

edutcher said:

“The insurance argument doesn't wash because you can always go to another insurance company.”

Insofar as health insurance is tied to employment (and it is to a very significant extent) you don’t choose your insurer, your employer does. Plus of course once you’re sick you’d be out of luck trying to change insurers, pending the prohibition of pre-existing condition rules in the hated Obamacare (which, I hasten to add, I am opposed to as well).

Dave said:

“not that private insurance companies don't have analogous bodies [i.e. ‘death panels’], they absolutely do, but their decisions are subject to appeal-to the courts, state insurance commissioners, etc.. the state panels are not subject to appeal, and if they deny life saving treatment, you're done.”

Again insofar as insurance is tied to employment this is simply not the case, expect in very limited circumstances. Employment-based “insurance” policies are virtually unenforceable in court, and state insurance commissioners have no effective jurisdiction due to federal preemption of state law by ERISA. For all practical purposes you really have no effective recourse when they cheat you out of benefits you are owed.

Thank you - I did not notice the 'prior' nuance, so you might well be right there.

Still, Avastin's website at http://www.avastin.com/avastin/hcp/breast/index.html states that "The effectiveness of Avastin in metastatic breast cancer is based on an improvement in progression free survival. There are no data demonstrating an improvement in disease-related symptoms or increased survival with Avastin. "

I would assume "increased survival" as the more critical metric than "progression free survival".

I am not an expert and might be missing a nuance here as well, but if the website of the drug claims that there is no data that shows it increases survival rate, and yet, also states that there is a 1.7% risk of fatality - isn't the FDA obliged to block it for MBC?

Those who are opposed to any kind of heathcare reform will grasp at any straw to prove their point. They seem to forget that the healthcare providers have been routinely refusing treatment approved by the FDA for decades. This is their own "death panel". For those of us who have good insurance, healthcare is good. For the millions with inadequate or non-existent healtcare, it is a nightmare and has been for decades.And reading the whole article would prevent the tidy righties from their tone of righteous indignation, which is their modus opererendi of the moment. Get over yourselves. Sarah Palin and her ilk are, as usual, wrong.

I went straight from undergrad to law school. Due to this fact, I was able to stay on my parents' insurance (not much of a choice, when deciding between a plan that covers essentially everything at almost no cost to me or my parents).

Of course, this "choice" ended up backfiring in a pretty significant way. At the age of 24, with about 3 months before I would no longer be covered by my parents' insurance, I was diagnosed with MS. The medication prescribed for this costs between $1,500 and $2,000 a month.

DBQ - what "choice" in insurance companies do I have now? Imagine me going to an insurance company and saying, "I have a disease that will require medication costing at least $20,0000 a year (plus any additional medications that may be necessary), doctor recommended contrast-MRIs of my brain and spine at least twice a year, various other tests. Oh, and also I'll need coverage for things not related to the MS."

"Pre-existing conditions" form the basis of "Death Panels" at every insurance company in the nation. There is no "choice." I have the choice of either finding a way to get extremely wealthy, or wait around as the disease continues to progress, as I continue to lose feeling and strength in my limbs, as I lose control over my bladder and bowels, as my mind deteriorates.

Yet, you all are talking about "Death Panels" because the FDA might rescind approval of a drug for a kind of cancer?

""Pre-existing conditions" form the basis of "Death Panels" at every insurance company in the nation. There is no "choice.""You can thank state and federal regulations for screwing all that up, of course. They made competition impossible, then came in to 'save the day' and fix the mess they created. And statists cheer them on, as they destroy yet another nation.

"starting to see that the Left is just plain stupid."Seems like Premium Stupid to me, with extra lead.

"There are those that look at things the way they are, and ask why? I dream of things that never were, and ask why not?"

Yeah, like why not sleep with Marilyn Monroe even when you're married? Why not sleep with the moll of a mafia don? Why not sleep with a campaign worker, and drive her off a bridge to drown? Why not audiotape MLK having sex with another women?

Those Kennedy brothers, always asking the best 'why not' questions. What could possibly go wrong?

So, you present to me a list of countries from a study I've already mentioned and debunked. What exactly do you think this proves?

@James. Tough situation. State high risk pools are the mechanism for people like you. In MD., we've got a good one. Most states don't, this needs to be fixed (something else Obamacare makes a nod towards doing...then doesn't do)

@Vicky. Straw man. Show me where anyone here is "opposed to any kind of heathcare" reform". Many of us have real, solid actual reform proposals, and certainly we'd be glad to discuss them on their merits. Opposing this abortion of a law (Obamacare) doesn't mean that one is "opposed to any kind of heathcare reform", just the opposite in fact. Most of us in opposition want reform that will increase competition, preserve choice and lower costs, and we can tell you how to do that too. This law does none of those things, and thus we oppose it. We do not oppose badly needed reform.

Goddamn, ever since I emigrated here, I have been amazed at the depth of dishonesty in U.S. advocates of government health care, in the face of readily accessible information about how it logically must end, in Canada.

The only argument they have left after that, is to claim that the Canadian implementation is bad, but the idea is still sound. The insult to Canadians aside, they might as well say that the reason we don't have a functional perpetual motion machine is because all the attempts so far were bad implementations.

Let me kill that one now. Perpetual motions machines, like government medicine, are wrong in principle and therefore a guaranteed failure in practice. The flaw in government health care, is government.

Assuming, of course, that good health care for all actually is your goal. If what you are after is *power*, of course, than government health care works just as well as government control of any other sector.

2. the medical delivery system you ad hominem are spooked about actually does a lot better job of keeping citizens alive and healthy on every measurement from infant mortality to life expectancy.

This has been so repeatedly debunked that it is really embarrassing seeing this tripe here. Our infant mortality figures look bad because we count premies who take a breath as alive. The countries that allegedly have better infant mortality than we do, don't. Mostly, if the baby isn't alive a day or so after being born, it is not considered in their statistics, but is in ours. It is comparing apples to oranges. And similarly with life expectancy. That figure includes drive by shootings in East LA, as well as the 50,000 or so car accidents a year. Why anyone with a shred of integrity would consider either figure a viable or even remotely relevant metric about health care is beyond me.

If you want to compare apples to apples, try comparing survival rates of heart attacks, strokes, and different types of cancer. And if you do, you will be shocked at how bad the figures are with most of the rest of the world, and esp. with such countries as the U.K. and France.

Maybe. I've been involved in several cases where insurance commissioners have required insurance companies to cover stuff, and fined them too. What I do NOT know is how that relates to ERISA, so I won't speak to it without finding out.

Oh Pogo please give me a break, as though insurance companies really are competitive; they all set rates on how much will be spent on procedures and deny coverage for some approaches.

If you could actually prove this, you could make a pretty good penny in an anti-trust suit against the insurance companies. It is illegal to conspire to set rates.

That, of course ignores that rates are most typically approved by state insurance commissions or the like, and if they let one company raise their rates a certain amount, they are invariably pressured to do so for others. What that means is that any conspiring to set rates is only viable because of the state involvement.

ok bruce. show me where they are excluded in other countries and included in the US. i didn't see it on several of the sites that I looked at and we are generally about the same in the rankings....so show me that footnote please.

perfectly willing to admit to making a mistake but you need to show me and then you need to show me where the US is #1 when that mistake is corrected.

There are those that look at things the way they are, and ask why? I dream of things that never were, and ask why not?

The "why not" is sometimes due to physical limitations (we can't just pop up to Mars for a quick sightseeing tour because of that silly little problem about going faster than the speed of light) and sometimes due to the sad fact that there is nothing the government touches that it doesn't royally screw up. The military is pretty much the only exception.

What is the difference between government death panels and insurance company ones? Obviously, you can shop insurance, at least if you are willing to pay for it.

But the big difference is recourse. With the government, you have none. You can appeal one level, but ultimately you will have one level of bureaucrats that you cannot appeal from.

With private insurance, you always have recourse to the court system. And, I know lawyers who make a lot more money than I do by suing insurance companies who don't pay for things that they should have paid for. It is called Bad Faith, and more recently, Outrageous Conduct.

The difference is that the government has sovereign immunity from most lawsuits, and this means that you have no recourse when the bureaucrats deny your claim. You have to, essentially, prove willful and wanton behavior. If you can prove that the bureaucrat denied your claim because he doesn't like you, personally, you may win. But not if he just doesn't like women with that type of breast cancer, and would rather see the money being spent on prostate cancer (assuming, arguendo, that we have a man making the decision - after all, women already get too much of the health care dollar, and esp. when it comes to sex specific cancer).

Proponents of socialized medicine, and, as a consequence, of government run "Death Panels" seem to have an amazingly optimistic view of governments and the bureaucrats who make the decisions in them. And, this applies to socialism in general. One wonders if they have ever had to deal with the IRS, DMV, etc. And, maybe that is why many people start out as Utopian liberals, but move towards conservatism as they age - as they have more and more experience with faceless and nameless governmental drones.

Those who are opposed to any kind of heathcare reform will grasp at any straw to prove their point. They seem to forget that the healthcare providers have been routinely refusing treatment approved by the FDA for decades. This is their own "death panel". For those of us who have good insurance, healthcare is good. For the millions with inadequate or non-existent healtcare, it is a nightmare and has been for decades.

And your solution is to significantly reduce the health care available to most of us in order to provide marginal benefit to a much smaller number, many of whom are arguably less deserving, if for no other reason than they aren't paying for it.

I'm sorry to hear of your condition and believe me I understand your predicament. My husband was diagnosed with diabetes several years ago and is totally unable to get health insurance.

We pay for everything for him in cash which in the last few years has included a bleeding ulcer and last week a work accident that almost took off a finger. We are walking a tightrope without a net every single day. We also don't qualify for any of the free gimmies that the government hands out like party favors.

I don't know what the answer is for people with pre existing and chronic conditions, but it isn't insurance.

We cannot demand that insurance companies insure the uninsurable and pay for conditions that they know already exist. First of all.....that defies the concept of insurance. Secondly it penalizes the other people participating in the pool who are healthy by unfairly raising their premiums to cover the already sick.

Perhaps this, and only this, situation of uninsurables would be a good use of government coverage, up to a limited point. Otherwise we are just switching the unfair burden from the healthy insured to the working taxpaying public.

Whatever happened to charity and charitable institutions as a way to cover the indigent and help the terminally ill.

what "choice" in insurance companies do I have now?

The choices we have now in insurance, that will NOT be available under the Obamacare rules, is to choose a high deductible plan. To choose a plan that does NOT cover things we don't need. I'm 60 years old. Why in the world should I be forced to buy a policy that covers maternity care. If you are a single man, why should you? Yet this is what has been proposed.

If the government wants to cover everyone for everything, we are going to find out that it is impossible, The coverage and quality of care for everyone will go down due to excess demand over supply. Pogo can only see so many people in a day you know.

Trade offs are part of life. If people are willing to trade the quality of care and the length of other people's lives for their own then Obamacare will prevail. I hope that people are not willing to sacrifice others on that altar.

Wait till they move the specialist end from UC Davis to Bangalore Medical College.

I actually wouldn't mind some off-shoring. For example, a friend has worked in ERs for decade now, and they read their X-rays "hot", and treat accordingly. But the X-rays have to eventually be read by Radiologists. That is the sort of thing that can easily be sent to India.

Here is the big thing though - if your insurance company forces you to use an Indian doctor, or your local physician consults with one, and he doesn't do an adequate job, then you can sue either one, esp. since the Indian docs are invariably not licensed here. But if the government forces you too, then you are SOL. That pesky sovereign immunity thing again.

Back in the early days of the "health care" discussion the stated objective was to insure the teeming masses of people who had so insurance, who were dying in the streets. And not one fucking leftie on this blog has mentioned how splendid it now is for the poor dying uninsured. All they want to do is prove that there are no "death panels." They don't and never did give a rat shit about the uninsured. They want the free fucking insurance for themselves. hahahahahahahahahah

I am sure that posting this after so much effort by the trolls is a waste of time, but here goes:

Richard Dolan is right. Someone has to make the final decision on the the comparative value of doing a medical treatment or not doing it. Me, with my own earnings (which includes buying insurance), or a bureaucrat with the earnings of others. There are no other options.

When I was in med school in the 1970's, we already had "death panels"- there were only 6 dialysis machines in our state, and that is all the state would buy. So, we had to decide which kidney patients were virtuous enough to get treated with dialysis, and which would suffer a lingering death without it. Congress thought this was terrible, and began providing unlimited funding for dialysis. Problem solved.

Now we have reached the point where Congress can no longer throw ever larger bales of money into the system. Someone has to say no. I want it to be me, and not a government clerk.

(BTW, there is an appeal process in government health care. In the federal health services, it is called a "Congressional Inquiry". So, your Congressman is the real final authority on whether or not you get otherwise unapproved heroic treatments. Make sure your contribution to his reelection campaign is big enough.)

ok bruce. show me where they are excluded in other countries and included in the US. i didn't see it on several of the sites that I looked at and we are generally about the same in the rankings....so show me that footnote please.

Which are you asking about - what is included in infant survival rates in different countries? Or what is included in life expectancy?

If you are the one spouting statistics, I would think that the burden would be on you to provide the standard by which, for example, a live birth, is determined. Either the studies you are citing specifically state how such is defined, or if they don't but instead rely on self-reporting by each country, then the studies are not worth the paper they are printed on.

So, we will all wait for you to provide us with the standards under which the statistics you cite were collected. What was included in different countries as live births, and what was excluded from life expectancy (and if nothing is shown, then we can assume that they include the East LA drive by shootings).

Any reputable study is going to show these limitations in the study somewhere, and any legitimate reporting of such will include them as at least fine print.

“With private insurance, you always have recourse to the court system. And, I know lawyers who make a lot more money than I do by suing insurance companies who don't pay for things that they should have paid for. It is called Bad Faith, and more recently, Outrageous Conduct.”

You know I do not wish to be a broken record about this, but the misconception just seems to be so ingrained and it is so incorrect.

The insurance companies, when coverage is provided (as it is in the vast majority of cases) through employment, have absurd immunity from liability for everything up to and including outright fraud and wrongful death. Bad faith in particular is preempted by ERISA – it just plain is not available to an aggrieved claimant. They are bulletproof, and they know it, and that’s how they act.

I’ll not link to my own blog again because, honestly, this isn’t about blog-whoring. You can google ERISA and bad faith and find lots and lots of other sources besides me. I really think the big overlooked problem is that people who get their insurance through their work should consider themselves to be among the ranks of the uninsured: what they have isn’t insurance, it’s an essentially unenforceable promise by an insurance company that they’ll pay claims when they feel like it. If they don’t feel like it, there’s precious little you can do about it.

1. Nancy McCaughly politian from NY compiled the cancer one...glad you like what she wrote over the world health organization but, hey, no accounting for taste.

2. The study on infant mortality is from 1992 meaning it studied data that is now 20+ years old.

3. The opening sentence in the longevity reads, and I quote: "Life expectancy in the United States fares poorly in international comparisons, primarily because of high mortality rates above age 50".

wow that is some slambang job of data collection. so authoritative. i'm particularly impressed by very old data. did you know that camp diseases were the biggest cause of death in the civil war and that most of the men were under 40?

wow that is some slambang job of data collection. so authoritative. i'm particularly impressed by very old data. did you know that camp diseases were the biggest cause of death in the civil war and that most of the men were under 40?

Wasn't it one of your unsubstantiated nine medical patents that cleared that up, HD?

Bruce Hayden said... "If you are the one spouting statistics, I would think that the burden would be on you to provide the standard ..."

hold on bruce. i used World Health numbers that are documented and universally referenced. You said that they were wrong because they didn't include drive by shootings in S/Cent LA (your words not mine) and now it is up to me to prove exactly what Bruce?

From your typical deer in headlights "i got nuthin'" comeback..you got nothing and you got caught yet once again with nothing.

some of you right wing bozos are so easy it scares me the danger we are in....

You know, if the FDA eliminated Phase III trials, in which the drug company is required to prove the efficacy of a drug, you would considerably reduce the development costs of a drug. You would also get the drug to market sooner, and increase the number of years (of its patent) over which it has to earn back its development costs, further reducing its cost.

That is, ironically, a major chunk of the cost of an expensive drug is the cost of the FDA's approval itself. It's weird to see the FDA frowning on the expense of drug which is only as expensive as it is because of their own actions.

Let the FDA restrict itself to preventing dangerous drugs from coming to market, drugs which have only bad effects, or for which the bad effects significantly outweigh the bad effects of the disease being treated. They can also provide solid summary and statistical information that simply lays out clearly the side-effects for any regular joe to understand. That would be far simpler, and cheaper.

Then let each individual and his physician decide whether a drug is right for him. Maybe it's effective, maybe it's not -- but let each individual make up his own mind, since he's spending his own money, and risking his own life.

hold on bruce. i used World Health numbers that are documented and universally referenced. You said that they were wrong because they didn't include drive by shootings in S/Cent LA (your words not mine) and now it is up to me to prove exactly what Bruce?

Ok, what standards did the World Health number use for determining live births and what was included in life expectancy? Did these standards vary, country by country? Were any of the numbers self-reported?

You are arguing by appeal to authority, the authority being the World Health organization, and all those who accept their figures. But, in the end, it comes down to the standards under which the studies are conducted, and not how many have accepted their numbers as authoritative. The old computer adage, GIGO, is applicable here.

From your typical deer in headlights "i got nuthin'" comeback..you got nothing and you got caught yet once again with nothing.

Don't need nothing. You are the one trying to use statistics to make a point. And in order to do so, you are going to need to do more than just waive your hands and say, the world health organization, or whatever, said they were accurate.

Again, if you want to use statistics here, please provide us with links to the conditions under which the statistics were gathered. What is included in the statistics and what is not?

when you get beat like you guys just got beat you can dig your holes deeper yet but my advice is to just give it up. hmmmm let me see....Nancy McCaughley v. World Health Organization...hmmmm Nancy/World Health...ahhh yes. I think I'll go with World Health. Et tu? No? tsk tsk.

Pogo get a grip on the propaganda. Insurance companies have blocked any reform for health or any federal laws which would regulate them and turned health care into a big business that pays well. Check this out to see why they can do thisWashington, DC – The HMO and insurance industries have spent a breathtaking $768,864,642 since 2007 on federal lobbying to influence public policy and elected officials, according to Health Care for America Now (HCAN),Further research for future drugs is often now done at universities under federal grants and will not stop any time soon and will not dry up.

I'm sympathetic: my partner is a breast cancer survivor, and cannot get insurance for love or money outside of the employer based group market. So she's nailed to the employer until Medicare kicks in.

Isn't the solution for you (and James above, and many of us) to cut the evil cord that ties health insurance to employers, which is just a stupid matter of tax policy?

No one can save you from the expenses of grave illness. Or, more precisely, we can't all save each other. But we can save ourselves, and if insurance weren't tied to employers, any sensible person would.

You'd buy a health insurance policy (or rather your parents would buy one for you) when you were born. Your parents would pay the premiums until you turned 18 and got a job, or it would be part of your college costs until 22, whatever. It would travel with you, from job to job. If you went three months between jobs, it doesn't matter, so long as you keep up the premiums (and that's just part of the cost of being unemployed, and if we want to be charitable, as a society, we factor it into unemployment insurance). If you go part time or start your own business or travel overseas, same thing. Because the policy is yours, and as long as you pay the premiums, you're covered. (Naturally, also, you can pick the policy that works best for you. Men can drop maternity and breast cancer coverage, women can drop prostate cancer coverage and maybe put high deductibles on motorcycle accident coverage, et cetera.)

But the big point is that for any reasonable person there wouldn't be such a thing as the cruelty of "pre-existing conditions," because you'd be continuously covered from birth. (Maybe we want to make it from before birth, to cover birth defects.) So nobody would be excluded from the risk-pooling inherent in insurance schemes except by his own deliberate choice of failing to pay the premiums and dropping coverage.

As for why loads of normal health people would sign up for such plans, spreading the risk widely and keeping premiums low: why, for the same reason they sign up for employer-provided insurance. People aren't stupid. Just a few horror cases of people who foolishly let coverage lapse and then had enormous medical bills would provide all the motivation people need. Paying your premiums continuously would become as much a personal existential necessity as paying for your food continuously, which is the way it ought to be.

I'm sympathetic: my partner is a breast cancer survivor, and cannot get insurance for love or money outside of the employer based group market. So she's nailed to the employer until Medicare kicks in.

Isn't the solution for you (and James above, and many of us) to cut the evil cord that ties health insurance to employers, which is just a stupid matter of tax policy?

No one can save you from the expenses of grave illness. Or, more precisely, we can't all save each other. But we can save ourselves, and if insurance weren't tied to employers, any sensible person would.

You'd buy a health insurance policy (or rather your parents would buy one for you) when you were born. Your parents would pay the premiums until you turned 18 and got a job, or it would be part of your college costs until 22, whatever. It would travel with you, from job to job. If you went three months between jobs, it doesn't matter, so long as you keep up the premiums (and that's just part of the cost of being unemployed, and if we want to be charitable, as a society, we factor it into unemployment insurance). If you go part time or start your own business or travel overseas, same thing. Because the policy is yours, and as long as you pay the premiums, you're covered. (Naturally, also, you can pick the policy that works best for you. Men can drop maternity and breast cancer coverage, women can drop prostate cancer coverage and maybe put high deductibles on motorcycle accident coverage, et cetera.)

But the big point is that for any reasonable person there wouldn't be such a thing as the cruelty of "pre-existing conditions," because you'd be continuously covered from birth. (Maybe we want to make it from before birth, to cover birth defects.) So nobody would be excluded from the risk-pooling inherent in insurance schemes except by his own deliberate choice of failing to pay the premiums and dropping coverage.

As for why loads of normal health people would sign up for such plans, spreading the risk widely and keeping premiums low: why, for the same reason they sign up for employer-provided insurance. People aren't stupid. Just a few horror cases of people who foolishly let coverage lapse and then had enormous medical bills would provide all the motivation people need. Paying your premiums continuously would become as much a personal existential necessity as paying for your food continuously, which is the way it ought to be.

when you get beat like you guys just got beat you can dig your holes deeper yet but my advice is to just give it up. hmmmm let me see....Nancy McCaughley v. World Health Organization...hmmmm Nancy/World Health...ahhh yes. I think I'll go with World Health. Et tu? No? tsk tsk.

beaten like rented mules...hahahahaha.

What are you smoking, today? Please point to anywhere in the above thread where I argued the point either way. Then, when you've failed to do so, please realize that I could care zilch about the topic at hand, and only slightly more about watching you make an ass of yourself as you are so predictably wont to do.

I'm sympathetic: my partner is a breast cancer survivor, and cannot get insurance for love or money outside of the employer based group market. So she's nailed to the employer until Medicare kicks in.

Isn't the solution for you (and James above, and many of us) to cut the evil cord that ties health insurance to employers, which is just a stupid matter of tax policy?

No one can save you from the expenses of grave illness. Or, more precisely, we can't all save each other. But we can save ourselves, and if insurance weren't tied to employers, any sensible person would.

You'd buy a health insurance policy (or rather your parents would buy one for you) when you were born. Your parents would pay the premiums until you turned 18 and got a job, or it would be part of your college costs until 22, whatever. It would travel with you, from job to job. If you went three months between jobs, it doesn't matter, so long as you keep up the premiums (and that's just part of the cost of being unemployed, and if we want to be charitable, as a society, we factor it into unemployment insurance). If you go part time or start your own business or travel overseas, same thing. Because the policy is yours, and as long as you pay the premiums, you're covered. (Naturally, also, you can pick the policy that works best for you. Men can drop maternity and breast cancer coverage, women can drop prostate cancer coverage and maybe put high deductibles on motorcycle accident coverage, et cetera.)

But the big point is that for any reasonable person there wouldn't be such a thing as the cruelty of "pre-existing conditions," because you'd be continuously covered from birth. (Maybe we want to make it from before birth, to cover birth defects.) So nobody would be excluded from the risk-pooling inherent in insurance schemes except by his own deliberate choice of failing to pay the premiums and dropping coverage.

As for why loads of normal health people would sign up for such plans, spreading the risk widely and keeping premiums low: why, for the same reason they sign up for employer-provided insurance. People aren't stupid. Just a few horror cases of people who foolishly let coverage lapse and then had enormous medical bills would provide all the motivation people need. Paying your premiums continuously would become as much a personal existential necessity as paying for your food continuously, which is the way it ought to be.

FLS: The concept of the poor uninsured was dropped over a year ago. Not a peep about it. Not one. Because where there were no death panel for the poor uninsured before there certainly will be now. Imagine people like HD House making the decisions. Give it some thought.

Why is Canada’s infant mortality rate higher than those of most peer countries? Part of the answer may lie in international differences in the registration of babies with an extremely low birth weight or countries’ classifications of births as live births or stillbirths. Some researchers suggest that comparisons between countries should therefore be interpreted with caution.6 A European report on perinatal indicators, for example, noted a wide variation in how European countries define infant mortality, due to differences in birth and death registration practices (that is, differences in the cut-off points for acceptable weight or estimated gestation period to be registered as a birth and subsequent death).7 This discrepancy can lead to under-reporting of infant deaths by some countries, particularly when compared with countries that use a broader definition for live birth. The international discrepancies in data may have existed for some time, but they have been overlooked because of much higher infant mortality rates. Now that rates are so much lower, however, differences in registration may be more important in explaining inter-country differences in infant mortality.8

The demographics of the USA are also significantly different from the other developed nations. Look at the chart in the Canadian article ... err ... talk about "lack of diversity." Those countries are all more homogeneous than MSNBC.

When the government owns your health care... they get to call the shots. (Sorry.)

Bureaucracies do not give a rats ass about individuals.

As Hagar so astutely remarked @ 2 PM, it is one thing for me and my doc to look at health care choices and I can figure out how I can pay for it.

It is another whole different and very offensive thing for the government to tell me I am not worth treating. (With money they have extracted from all the "rich" people and my neighbors and maybe me.)

And BTW -- as I mentioned in the previous thread about this "NICE" is the name of the death panel in Britain which denied the right of a Brit to use drugs SHE BOUGHT WITH HER OWN MONEY for her own treatment because the NICE panel had determined they were too expensive for NHS. She sold her house to do it. (Go look up the link. I'm busy.)

NICE also has put a value of ~$49,000 on your a life wrt medical care.

There is a clear rationing system in Britain and the waiting list in s now down to several millions waiting several months (again, referenced in links in older posts back when this wonderful Obamacare bill was going to solve all our problems and not cost us anymore and pay for itself. /s I have beautiful rainbows in my back yeard, onlyt for real.)

Also -- I will look this up later. IIRC, a couple was suing the government last year because they were not allowed to pay for medical care they wanted that Medicare did not cover, but because they were receiving SS and Medicare they HAD to go by the restrictions Medicare had. I may not have the details right, so will go find it, but yes, there are already problems with people on federal health plans (well, not the Congress and the rest of DC).

when you get beat like you guys just got beat you can dig your holes deeper yet but my advice is to just give it up. hmmmm let me see....Nancy McCaughley v. World Health Organization...hmmmm Nancy/World Health...ahhh yes. I think I'll go with World Health. Et tu? No? tsk tsk.

Not sure I am smart enough to understand why we are beat here. I am still waiting for the specifics of the studies that you are citing. In particular, I am interested in the parameters of the studies - what was included, and where they came from. Throwing around the name "World Health Organization" doesn't answer that request.

I assume that you understand that invoking authority, as you seem to have done here, is typically considered one of the classic types of fallacious argument.

WV: nopat - what I will be today if I don't finish that patent application that I am working on.

Wow HD, you really are a jackhole. You're why I don't usually bother correcting hardcore libs, you don't care about facts, just regurgitating verbatim what you've been told. To address your points in order:

1. The facts cited in the linked article are individually footnoted, Dillweed. Address them, not whoever the author of the study is.

2. The study from the CBO, if you'd bothered to read it, highlights and explains how different countries collect infant mortality different ways, which was exactly what you called into question. Also, you dismiss it because it's from the 90s, but your own decade old WHO report is supposed to be definitive?? Gay kakken af en yam.

3. The first line does say that, but you conveniently ignored the conclusion: "We conclude that the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system. " The role of violence on the stat is examined as well, which again, was the point I was making.

Let's face it Chester, you're standing here with a limp dick in your hand. You demanded cites, when they were provided you refused to discuss the facts within them, but resorted to ad hominem attacks and insults. You obviously got nothin'. Go away kid, you bother me. Come back when you grow up a little.

@Dave you're starting to get it. People like HD aren't interested in debating and discussing. Any effort to bring reality into a discussion with hardcore lefties like HD or Alpha is a waste of time. In their quaint little world reality is nothing but lies, convervative lies.

You cannot debate with them, discuss with them, negotiate with them, or deal with them. You can can only laugh at them.

RV;as though insurance companies really are competitive; they all set rates on how much will be spent on procedures

Believe me there is quite a bit of competition. Keep in mind the major source of dollars for health insurance outside of governmental plans (i.e. medicaid) is through employer groups. There is intense competition between health plans to get these contracts.

Now if you're speaking about individual plans, because the total dollars are smaller there are likely fewer companies competing for that business. However, since the mandate is on the way there are more and more companies developing those lines of business.

As for health insurance companies being against "health care reform" they met with and agreed in principle to the Presidents goals very early on. And that was with the knowledge that they would likely be "demonized" as the politics played out. They were correct.

As someone who knows the business, they're still generally in favor of the changes. The bill will do a lot for coverage/access. Unfortunately it has done little for the other two legs of the "three legged stool", quality and cost.

AS I've written before, cost is a huge issue not just here in the US but in all of those countries with universal access. Unfortunately, we have a "head start" (we've been paying a lot more per capita for a long time). For example, over the past few years, England has a higher medical inflation rate than we do.

We can argue all we want as to who will make the difficult coverage decisions for certain therapies, government or private enterprise. As a physician my desire would be that it would solely be a decision between a physician and his/her patient. Unfortunately, with costs of many interventions out of the reach of ordinary citizens a third party is likely to be involved for the foreseeable future.

wrong. wrong and wrong. try and keep up. the WHO report grades the general level of health care provided to citizens in a country taking into account numerous factors in many different catagories. 2008 data shows little change in the lineup except China seems to be sinking lower and lower.

You come back with 1. questionable and politically motivated 2. very old and 3. mixing drive by shootings of younger people with longevity.

i admire that you can navigate a candy store and pick what you want but i prefer to look at the whole candy store. and when you trot up the register with some bad choices don't start weeping when you are called on them.

No, not wrong. I've presented facts, figures and cites, you keep parroting "The WHO, The WHO, The WHO..." I've addressed specific problems with the WHO report, and you keep chanting "It's the WHO, it's the WHO". I'm beginning to believe that you are too stupid to even realize what an appeal to authority fallacy is.

I appreciate your thoughts, and I am sorry for your husband's situation. But I think I have to respond to one bit in your otherwise pretty well thought out response.

"Perhaps this, and only this, situation of uninsurables would be a good use of government coverage, up to a limited point. Otherwise we are just switching the unfair burden from the healthy insured to the working taxpaying public."

This would certainly not be quite as unpopular as a total healthcare overhaul, but would likely be met with the same cries of "socialism!" and "unconstitutional!" as Obamacare has been (though toned down a little, due to the sensitivity of the situation).

And if it was "up to a limited point," aren't we directly getting into the "death panel" area again? Let's say that it will only cover my medication for a year or two or five (I have found one private organization, partially run by the drug manufacturers that will provide up to one year's worth for those without insurance), isn't that the exact same situation that people are railing against in this thread? Especially since with MS, having only a couple years of the medication is pretty pointless - it is designed to prevent/slow down future relapses, and minimize the permanent damage that comes from those relapses. So a years worth of medication would hardly do anything, except maybe soften the blow for a year.

I give up. you've take data from three different sources, none of which are top drawer authority (the former Lt. Gov of New York for heaven's sake and with a report written as a push back to health care) against the World Health Organization that has operated as the world's central medical data point for 50 years..you cherry pick the "facts you want to present" ... litle bitty fact areas and you match them up against the top level findings of the world's medical data authority and it leave it up to others to prove you are wrong?

I've lived in Canada 26 years. My most recent surgery I waited to see the first specialist nine months and 2nd another nine months. The 2nd, a surgeon, put me on a waiting list. Although I had a problem that involved pain and constant bleeding I didn't have actual cancer which was required by the hospital guidelines to move me up their list. I waited a year and a half but was bumped the morning of surgery by a walk-in to Emergency. I had been all prepped so my nurse told me stories about the great private plan she and everyone in England uses. Her last surgery was like going to an upscale hospital and for not much more than the public plan!

I went home, we called our Member of Parliament, protested to the hospital administrators and by some miracle, six weeks later they found an opening in their surgical schedule and I finally was operated on.

The biggest problem in Vancouver is not enough hospital beds. The current provincial government is pro-business and eliminated two hospitals, cut budgets and the waiting lists are now even more horrific. A few specialities aren't as bad, but after I left the hospital I had 30 people my age (exactly 30, I counted) tell me their Canadian medical plan horror stories. One of the worst begins "I was lying in the hall, listening to my surgeon scream at the head of surgery "I will not let my patient die out here on a stretcher!" She'd been out there for two weeks. She said that during Communist times she'd had much better medical care in Romania.

I asked several cousins who are nurses and doctors here in the states why your newspapers only published positive stories about all the problems in public systems, both here in Canada, and in England and Europe. They had whitewashed them to such and extent they made them seem idyllic! According to these cousins the current government was so insistent on passing this particular bill, without any Republican support, they and the newspapers ignored the bad news. I feel incredibly sorry for you all. Right now, my American sister-in-law needs Avastin with her type three breast cancer. I really hope there is some way for her to get it. I had no idea it had gotten so bad so quickly until I came down to San Francisco to visit. Luckily, we do have more than one doctor in our family, and the rest are mostly lawyers. All I can say is this entire Healthcare bill is a boon for trial lawyers. If anyone here has ever had to wait a year and a half for surgery, while in terrible pain, there will be a lawsuit. We can't sue the government in Canada.

Let's say that it will only cover my medication for a year or two or five (I have found one private organization, partially run by the drug manufacturers that will provide up to one year's worth for those without insurance), isn't that the exact same situation that people are railing against in this thread?

Well, yes and no. I guess I'm more pragmatic than many people and realize that there has to be a limit on costs because we can't cover everything for everyone forever.

On the other hand.....if I am on the receiving end of the medical treatment, I would say cost should be no object.

The government being in charge and insurance companies are making these decisions using a cost basis analysis system.

Your doctor making these decisions is looking at you on a case by case system. I definitely prefer this to the first.

In the case of people who need ongoing medication, perhaps for life in order to have quality of life and prevent future diseases, I think the total cost should be less of a consideration

In the case of a terminal cancer patient who may have an additional year or two by taking an expensive course of treatment or who may die much sooner by not getting the treatment, how in the world can we leave that decision to government bean counters.

It is difficult to deal with death. We are ALL going to face it sooner or later. The question for all of us is at what cost? Cost to ourselves, our souls and to our families.

I don't know what I would choose and hope I never have to face the decision as my Aunt did. She decided to stop the experimental cancer treatment that had extended her life by almost a year beyond her "due date". She chose quality of life over quantity.

I give up. you've take data from three different sources, none of which are top drawer authority (the former Lt. Gov of New York for heaven's sake and with a report written as a push back to health care) against the World Health Organization that has operated as the world's central medical data point for 50 years..you cherry pick the "facts you want to present" ... litle bitty fact areas and you match them up against the top level findings of the world's medical data authority and it leave it up to others to prove you are wrong?

Can't you see that you look ever more desperate in getting people to accept your appeal to authority argument? Calling the WHO ever more authoritative and ladling on the adjectives just makes the weakness of that sort of argument ever more evident.

One big problem with the WHO is that it is political. The first thing I noticed when I brought up their web site was the U.N. logo. The U.N. is the same organization where Iran was apparently put Iran on the commission for women, or some such. It is also the organization that consistently votes to condemn Israel as a terrorist state, and that Zionism is equivalent to racism, etc. And, yes, the IPCC is also U.N. related and authorized, and we all know where that appeal to authority was leading us (yes, the organization that shared the Nobel Peace Prize with Crazed Sex Poodle AlGore for their AGW scare mongering).

You may chose to trust the U.N. and all of its sub-organizations, and their agendas, etc. But a lot of us, I think, believe that they are all highly politicized, and, in particular, heavily slanted against the U.S.

Either the WHO work will stand on its own merits, or it won't, which is what has happened to many of the IPCC AR4 reports.

The best thing about Socialism is that its advocates usually end up standing next to their erstwhile victims in front of the concrete wall, right behind the ditch.

I welcome this. Some people you just can't reach. But this is the way they want it. So, they should get it. Good and hard.

The only way to get through to some people is to make them watch their families suffer, or to make them suffer.

Bring it on, I say.

This nonsense has gone on long enough; 30, 40 years by my count. Let the baby boomers and their intellectual offspring tremble at the device of their own building. Let them feel pain. Let them feel hopelessness, misery, terror. Maybe it'll be enough to keep a few future generations from treading down the same path.

Just as significant is NHS rationing of lifesaving drug--for example, the bowel cancer drug Avastin and Nexavar, the only treatment offering any chance of survival for patients with advanced liver cancer--are routinely used in other European countries.

These drugs typically offer three to six months of extra life, but some patients can survive for years. Although the drug-approving body NICE agrees they work, it says the health system cannot afford them.

Yes, yes, yes, the article addresses colon and kidney cancer. But the key takeaway here is "rationing of lifesaving drugs" because "the health system cannot afford them."

Avastin costs -- oh, about $50K per year at discount. It definitely is the most studied of the invented antiangiogenesis agents. That being said, why is it that a PATIENT SUPPORT GROUP had to foot the bill for the following "add on" study of over-the-counter curcumin plus over-the-counter EGCG [key component in green tea? Surely there must be a number of antiangiogenesis compounds waiting for funding to PROVE their effectiveness. My understanding is that this research was purchased for the bargain price of about $100K

Wonder if the death panels will give preference to teachers, UAW members and the teamsters? Or just illegal aliens?

So how would this work? The FDA would set quotas/guidelines on who should be administered this drug based on their job or immigration status? Lawl. c'mon knox. I don't think the FDA could pull that off.

The FDA would set quotas/guidelines on who should be administered this drug based on their job or immigration status?

The government (the democrat president and democrat congress) is making decisions about who gets retirement/pensions/bailed out based on this criteria every day.

Don't know if you work for or own a small business, but this becomes very clear when you see big, incompetent businesses and their unions being bailed out--all the while, small businesses face numerous penalties through the 1099 fiasco, Obamacare, and tax increases.

Anyhow, I wasn't referring to the FDA. I was referring to the government, the bureaucrats in charge, which will be ushered in with the Public Option.

I don't know anything about Avastin, but I shoot up with Enbrel once a week for RA, and I wonder constantly how long that'll be paid for by insurance. My rheumatologist just declined to renew my Avandia prescription and referred me to a diabetes specialist. I think it was probably dictated by his malpractice insurer, even though the connection with heart attacks is probably only statistical. Guess what, people over 60 often have both diabetes and heart trouble, both of which can be developed after continued use of drugs for RA.

One of the things that most needed reform is our tort law, but that was not on the table for the Democrats.

Had a friend with a daughter at Uni who was looking for an internship in DC area. I introduced her to a friend at Commerce. In a telecon she expressed her interest in mining their data for new insights, and he waived her off "better for you to go to one of the Pharmas rather than here or anywhere in the USG.. we don't do statistics, we follow the law."

Which is the same problem many organizations have with self-reporting unless outsourced - the autopsies / after-action reviews the intelligence community did of the majority of their analysts' failure to forecast the USSR collapse came down to almost all of our secret collection systems reported numbers that documented the apparatchiks lying to themselves. Their leadership actually did not know the truth – and we trusted technical collection too much to deeply pursue hints of reality – food riots, etc..

This gets back to the faiths I've mentioned in other settings. You can either trust in a market of free individuals and their enterprise advancing the greatest common good, or you can get the worst of all results (by blending, confusing responsibility, disconnecting result from action, etc. Putting the state’s thumb on the scales and attempting fine control (v. one rule for all) however good the intention has always proven a mistake).

Of note is the discussion about (not) ~“approved use with chemo.” It's a product of our over-lawyered culture. It (simply) hasn't been $1B-dollar (double-blind) tested in those combinations. To suggest otherwise would leave them open to liability. Same as the words on the container that holds an Intel-processing chip - ~"not to be used when life at risk" (because they can't/won't certify it for that use.. so it’s up to the user to certify if they so need).

Good news is we have yet to take the license away from an M.D. to arbitrarily prescribe and try whatever they think is in the best interest of the patient. So we do get some of the benefit of the random-walk of use trials. Would be even better if we (the state) didn't play nanny to citizens in terms of what they could prescribe for themselves.

But, like with borders, birthright citizenship, 3rd party payers for medical care, granted egality v. earned success, etc., we can't have a free people and a welfare state. Though I’m sure we’ll keep on trying and failing (unless and until we decide to defund the federal government for anything/everything related to domestic issues – and push these issues down to the states, or even better each state segmented into 20 new-states – rather than just one place for special interests to influence, they’ll have to invest in 1000 local governments – which then by definition will make a special interest a local interest if/when successful).

That is to say, how much of someone else's money is it worth? In my case, a lot. Everything you got. You're not willing to give me all your money to keep me alive? What are you, some kind of one-person death panel?

This is actually quite a bit worse than the Obamacare death panels. The drug has some benefit, and the Obama administration doesn't want to admit they don't like it because of cost. So they get the FDA to take it off the market.

If they just refused to pay for it that would be bad enough, but if they take it off the market you can't even pay for it yourself.

"Wonder if the death panels will give preference to teachers, UAW members and the teamsters? Or just illegal aliens?"

Heh. Nations with socialized medicine tend to run a two-tier system: One lower level of care for the serfs and a second premium level for the masters. In fact, Victor Davis Hanson wrote about this a few months ago.

"The best thing about Socialism is that its advocates usually end up standing next to their erstwhile victims in front of the concrete wall, right behind the ditch."

Heh. And that's the moment when most leftists notice that something's wrong. A regime can murder tens of millions of mere peasants and the left will yawn. It's only when they start getting killed that they discover morality.

"It's the entire process, which, as Democratic Party leaders admitted, was merely a first step toward a national health service, by destroying private insurance."

Krauthammer:

"And here's what makes it so politically seductive: The end result is the liberal dream of universal and guaranteed coverage -- but without overt nationalization. It is all done through private insurance companies. Ostensibly private. They will, in reality, have been turned into government utilities. No longer able to control whom they can enroll, whom they can drop and how much they can limit their own liability, they will live off government largesse -- subsidized premiums from the poor; forced premiums from the young and healthy.***"Isn't there a catch? Of course, there is. This scheme is the ultimate bait-and-switch. The pleasure comes now, the pain later. Government-subsidized universal and virtually unlimited coverage will vastly compound already out-of-control government spending on health care. The financial and budgetary consequences will be catastrophic."

I blame Americans' lack for foreign language fluency for their fixation on the universal health care systems in Canada and the UK, and not on the successful ones in France, Germany, Israel, or the Netherlands, to name but a few..

Nowhere does medical care absorb so much of GDP as in the US -- there has to be a lot of low-hanging fruit to pick.

Avastin is a similar compound to Lucentis, which is a approved for age-related wet macular degeneration. It is the subject of studies by independent physicians now. Avastin has, so far, been safe and about as effective as Lucentis.

Ironically, Lucentis is about fifteen times more expensive than Avastin. The irony is that the FDA-approved drug is not the cheaper one. So at least in this case, the "Death Panel" isn't counting nickels.

Some of the backstory here is that both drugs come from the same firm, Genentech, which argues that each is narrowly designed for a specific purpose. Lucentis is produced to higher standards of purity and is eliminated from the eye much more readily. It is provided in smaller dosages (doctors or pharmacists have to divide Avastin into smaller aliquots to get macular-degeneration dosages).

Both drugs have been credited with saving elderly patients' vision, and neither would have been possible before genetic mapping and sequencing. In the future these incredible technologies will bring us more and more such embarrassing riches. If we stop fighting over it for a minute, perhaps we could all be grateful?

2007 The French national insurance system has been running constant deficits since 1985 and has ballooned to $13.5 billion.

And while there is a lot of good to be said about the French system -- France is also where Princess Diana died outside a Paris hospital in an ambulance she had been in for 90 minutes after she was injured in metropolitan Paris.

In the US she would have been in surgery for at least 45 minutes by then.

stop with the socialized medicine 'would have lived by took 90 minutes in an ambulance' bullshit. that is urban myth and that you would invoke what you know to be false into the discussion is absurd and contemptable. The ambulance departed the crash scene at 1:41 a.m. and arrived at the Pitié-Salpêtrière Hospital at 2:06 a.m.

It takes a real moron not to look up just the basic facts before you write something so stupid.

A largely bogus statistic. Diagnose cancer earlier and you get longer survival rates. Add to that diagnosing more and more cancers that would never be fatal and it twists the survival rates even more.

Your main argument seems to be that the U.S. gets a significantly higher cancer survival rate by detecting a lot of non-fatal cancers and including them in those who survived. Kinda like the problems with HD's statistics, except in reverse, where too many deaths were included for the U.S., not too few, through shoddy statistics.

And, you might have a point, if the comparisons stopped at the gross level of generic cancer survival. But, of course, it doesn't. Rather, when matching by type of cancer, the U.S. still has a significantly higher survival rate. And ditto for other types of maladies, such as stroke and heart attacks.